American Health Information Management Association (AHIMA) Certification Practice Exam

What is the term used for someone who steals and uses another person's insurance details to obtain medical care?

1. Violation of bioethics

2. Fraud and abuse

3. Medical identity theft

4. Abuse

The correct answer is: Medical identity theft

The term that accurately describes someone who steals and uses another person's insurance details to obtain medical care is medical identity theft. This refers specifically to the act of taking someone else's personal information, particularly insurance information, to receive healthcare services or benefits fraudulently. This crime not only affects the individual whose information was stolen but also can lead to significant complications for healthcare providers and insurance companies. In this context, other terms such as fraud and abuse encompass a broader range of deceptive practices in healthcare, but they do not specifically identify the act of using another person’s insurance details. Violation of bioethics involves unethical practices in medical research or patient care rather than the theft of identity. Abuse in healthcare usually refers to actions that result in unnecessary costs or harm, often due to improper practices but not necessarily tied to identity theft. Thus, medical identity theft is the precise term for this criminal act.